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CCRN > Acute Coronary Syndrome > Flashcards

Acute Coronary Syndrome Flashcards

1
Q

What is the difference regarding troop in between NSTEMI, STEMI, and unstable angina?

A

Troponin will be negative with unstable angina. Troponin will be positive in NSTEMI and STEMI.

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2
Q

Common cardioselective beta blockers

A

Bisoprolol
Esmolol

Metoprolol
Atenolol
Nebivolol

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3
Q

What is the advantage of cardioselective beta blockers?

A

They are 20x more potent at blocking beta 1 receptors than beta 2 receptors (and therefore much less likely to cause bronchoconstriction)

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4
Q

List 5 effects of beta blockers as they block sympathetic stimulation of the heart.

A

1) reduce systolic BP
2) reduce heart rate
3) reduce cardiac output and contractility
4) reduces myocardial o2 demand
5) increase exercise tolerance

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5
Q

EKG Changes in leads II, III and aVF

A

RCA,inferior LV

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6
Q

Inferior wall IS SUPPLIED BY WHICH CORONARY ARTERY?

A

The RCA

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7
Q

In Inferior wall MI, which leads will show changes?

A

II, III and aVF

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8
Q

The LAD supplies which two parts of the heart?

A

Anterior and septal walls

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9
Q

Changes in V1, V2, V3, and V4 are associated with which coronary artery, and which ventricle?

A

The LAD or the anterior LV

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10
Q

Changes in V5, V6, I and aVL Are associated with which coronary artery and part of the heart?

A

The circumflex and the lateral LV

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11
Q

Changes in V1 and V2 Are associated with which coronary artery and part of the heart?

A

The RCA, posterior LV

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12
Q

Changes in V3R, V4R, Are associated with which coronary artery and part of the heart?

A

The RCA , right ventricular infarct

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13
Q

Why is troponin/CKMB elevated after reperfusion?

A

Myocardium is “stunned” by vessel opening.

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14
Q

What type of arrhythmia are seen after coronary reperfusion?

A

VT, VF, AIVR (from myocardial stunning)

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15
Q

eligibility for PCI during STEMI?

A 
ST elevation in 2 or more contiguous leads 
New onset LBBB
onset of chest pain < 12 hours 
Chest pain of 30 min 
Chest pain unresponsive to SL NTG
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16
Q

AV conduction disturbances are seen in which type of MI?

A

Inferior (RCA occlusion)

Think 3rd degree HB

17
Q

Why might a systolic murmur develop during inferior wall MI?

A

Mitral valve regurge secondary to papillary muscle rupture

18
Q

The RCA supplies which parts of the heart?

A

The RV and inferior wall of LV

19
Q

An anterior MI indicates there is a lesion in which coronary artery?

A

The LAD

20
Q

New development of second degree type II heart block May indicate which type of MI?

A

Anterior MI (the LAD supplies the bundle of his)

21
Q

Heart failure is associated with which type of MI?

A

Anterior MI

22
Q

Most incidents of stent thrombosis occur when?

A

Acutely- within 24 hours of stent placement

Or Subacutely - within the first 30 days

23
Q

What is the difference between hypertensive emergency/crisis and hypertensive urgency?

A

Urgency- elevated BP

emergency/crisis - elevatedBP with end organ damage

24
Q

What is the PRELOAD?

A

Volume of blood in ventricles at the end of diastole

25
Q

What is the AFTERLOAD?

A

Resistance the LV MUST OVERCOME to circulate blood

26
Q

Nitroprusside reduces the preload or the afterload?

A

Both

27
Q

Prolonged qt interval is dangerous for what reason?

A

It may lead to torsades de pointes.

28
Q

Which drugs are known to cause prolonged qt?

A

Haldol, amiodarone, procainamide, methadone, sotolol, quinidine

29
Q

Pacemaker code
First letter =
Second letter =
Third letter =

A

Pacemaker code
First letter = chamber paced
Second letter = chamber sensed
Third letter = respond to sensing (inhibitions)

30
Q

What is the meaning of “failure to pace”?

A

No spike, or pacing beat, when expected

31
Q

failure to capture

A

Spikes occur without a QRS for ventricular pacing.

32
Q

Failure to sense

A

Pacer paces during native beats

33
Q

Anterior wall MI is usually due to LAD occlusion. LAD occlusion usually results in what kind of heart block?

A

Second degree; type 2 (because LAS supplies the bundle of his)

34
Q

Which type of MI Is most likely to result in a ventricular septal defect?

A

Anterior MI (occlusion of the LAD)

35
Q

Inferior MI is a result of a lesion in which coronary artery?

A

The RCA

Therefore, patient should be assessed for RV infarct with R sided EKG.

36
Q

Does morphine lower the preload?

A

It can ( and worsen hypotension)

CCRN (12 decks)

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